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瘤芽作为淋巴结转移和pT1结直肠癌局部复发的危险因素:系统性审查和元分析
Heng Zhang1, Femke Simmer1, Alessandro Lugli2
1Department of Pathology, Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands.
Gastro hep advances
|August 5, 2025
概括
瘤芽 (TB) 是淋巴结转移 (LNM) 和早期结直肠癌 (CRC) 局部复发的重要预测因素. 这一发现有助于为pT1 CRC患者选择适当的外科治疗.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 手术病理学手术病理学
背景情况:
- 人口查增加了早期结肠直肠癌 (CRC) 检测 (pT1阶段).
- 内镜切除是pT1CRC的标准,但淋巴结转移 (LNM) 和复发风险需要进一步治疗.
- 瘤芽 (TB) 是已知的pT1CRC的不良结局生物标志物.
研究的目的:
- 在pT1 CRC中调查结核病和LNM之间的关联.
- 为了澄清结核病与pT1CRC中的局部复发之间的关系.
- 为改进外科治疗选择策略提供证据.
主要方法:
- 对MEDLINE和EMBASE数据库进行系统审查.
- 用随机效应模型对57项观察性研究 (24,956名患者) 的元分析.
- 对结核病与LNM和局部复发的关联进行评估.
主要成果:
- 高度结核病与LNM (RR=4.04) 和局部复发 (RR=2.35) 有很强的相关性.
- 敏感性和子组分析证实了结果的稳定性,并注意到LNM的地理位置和出版年份的变化.
- 确定了对LNM风险的潜在出版偏见.
结论:
- 结核病是pT1CRC中LNM的强有力的预测因素.
- 结核病也可以预测pT1CRC的局部复发.
- 研究结果支持结核病在指导pT1CRC手术治疗决策中的作用.
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